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01-12-2009 | Original Article

Resistance against broad-spectrum β-lactams among uropathogens in children

Authors: Maria Bitsori, Sofia Maraki, Maria Kalmanti, Emmanouil Galanakis

Published in: Pediatric Nephrology | Issue 12/2009

Abstract

The aim of this study was to investigate the prevalence trends and risk factors for urinary tract infection (UTI) caused by Enterobacteriaceae resistant to broad-spectrum β-lactams in children. All Enterobacteriaceae uropathogens from children <15 years during the 11-year period 1997–2007 were included, and risk factors were evaluated. Of 523 Enterobacteriaceae isolated from 473 children, 30 (5.73%) were phenotypically resistant to broad-spectrum β-lactams (18 Escherichia coli, ten Klebsiella spp, one Enterobacter spp, and one Citrobacter spp). The prevalence of resistance increased during the study period (p = 0.031). Resistance to cefoxitin was common (26/30), pointing to AmpC enzyme expression, and 2/30 isolates were resistant to carbapenems. Resistant Enterobacteriaceae were often community acquired (22/30, 73.3%) and related to male gender (p < 0.05), urinary tract abnormalities (p < 0.05), prophylactic antibiotics (p < 0.0001), longer hospitalization (p < 0.001), and UTI recurrences (p < 0.001). Co-resistance was more likely for cotrimoxazole, gentamicin, and ciprofloxacin (p < 0.0001). In conclusion, our study points to increasing prevalence of Enterobacteriaceae uropathogens resistant to broad-spectrum β-lactams in the community setting, which limits the utility of first-line antibiotics and questions the validity of using prophylaxis after a first UTI episode.

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Title: Resistance against broad-spectrum β-lactams among uropathogens in children
Authors: Maria Bitsori
Sofia Maraki
Maria Kalmanti
Emmanouil Galanakis
Publication date: 01-12-2009
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 12/2009
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-009-1255-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Resistance against broad-spectrum β-lactams among uropathogens in children

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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